Dr. Amitabh Gupta, HOD Neurosurgery Batra Hospital, New Delhi.
Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and can interfere with normal movement, speech, and gait. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. The damage causes a change in the balance of signals between the nervous system and the muscles. This imbalance leads to increased activity in the muscles. Spasticity negatively affects muscles and joints of the extremities, and is particularly harmful to growing children.
Prevalence and Incidence
Spasticity affects more than an estimated 12 million people worldwide.
About 80 percent of people with cerebral palsy (CP) have varying degrees of spasticity. With an estimated 500,000 people in the United States with some form of CP, this equates to about 400,000 people with some degree of CP-related spasticity.
About 80 percent of people with multiple sclerosis (MS) have varying degrees of spasticity. With an estimated 400,000 people in the United States with MS, this equates to about 320,000 people with some degree MS-related spasticity.
Other conditions that may cause spasticity include:
Traumatic brain injury (TBI)
Spinal cord injury (SCI)
Brain damage due to a lack of oxygen
Stroke
Encephalitis
Meningitis
Adrenoleukodystrophy
Amyotrophic lateral sclerosis (Lou Gehrig’s disease)
Phenylketonuria
Symptoms
Spasticity may be as mild as the feeling of tightness in muscles or may be severe enough to produce painful, uncontrollable spasms of the extremities; most commonly the legs and arms. Spasticity may also create feelings of pain or tightness in and around joints, and can cause low back pain.
Adverse effects of spasticity include:
Muscle stiffness, causing movements to be less precise and making certain tasks difficult to perform
Muscle spasms, causing uncontrollable and often painful muscle contractions
Involuntary crossing of the legs
Muscle and joint deformities
Muscle fatigue
Inhibition of longitudinal muscle growth
Inhibition of protein synthesis in muscle cells
Treatment Options
There are several types of treatment available which must be evaluated on a case-by-case basis, depending on the underlying cause, age of the patient, and severity of the spasticity. Different treatments share the common goals of:
Relieving the signs and symptoms of spasticity
Reducing the pain and frequency of muscle contractions
Improving gait, hygiene, activities of daily living, and ease of care
Reducing caregiver challenges such as dressing, feeding, transport, and bathing
Improving voluntary motor functions involving objects such as reaching for, grasping, moving, and releasing
Enabling more normal muscle growth in children.
